Teaching behaviors in the attending-resident interaction

A total of 949 interactions between residents and attending physicians in the ambulatory care center were analyzed in terms of defined categories of teaching behavior by using direct observation and the interactional analysis technique of educational research. Results showed that an interaction reflects team problem solving as the predominant teaching mode with the interaction being for the most part directed at the problems of the current patient. Hypothetical situations that broadened the discussion occurred in less than 20 percent of the interactions, and the attending physician rather than the resident virtually always initiated those teaching opportunities. Questioning and verbal expressions of positive, reinforcing behavior were used less often than might have been expected. Problems and opportunities in superimposing teaching goals upon an ambulatory clinical setting are explored in the discussion.